Nevin Manimala

Graefes Arch Clin Exp Ophthalmol. 2022 Mar 29. doi: 10.1007/s00417-022-05597-7. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the role of cardiac autonomic neuropathy (CAN), vascular condition, and sensory function in diabetic retinopathy (DR) progression.

METHODS: This 3-year cohort study conducted in a community hospital included 4850 patients over 20 with type 2 diabetes mellitus. Participants were assessed in 2017 at baseline and were followed up in 2020. Patients were divided into two groups based on whether they had DR progression or not and were compared using the chi-square test or two-sample t-test. Beta coefficient and odds ratio (OR) with 95% confidence intervals were calculated using binary logistic regression. The receiver operating characteristic (ROC) curve of various independent variables for DR progression was provided with C-statistics.

RESULTS: Abnormal hemoglobin A1c (HbA1c) level/variation, estimated glomerular filtration rate, urine albumin-to-creatinine ratio, R-R interval variation, standard deviation of the average NN intervals, autonomic nervous system function, power of high-frequency (HF) bands, balance, cardio-ankle vascular index (CAVI), and warm stimulation (WS) were associated with DR progression. Average HbA1c, HF, and proliferative diabetic retinopathy were independent factors for patients developing DR progression. The top three areas under the curve of ROCs were HF + baseline DR grading, WS + baseline DR grading, and CAVI + baseline DR grading. These variable combinations were the most reliable predictors of DR progression.

CONCLUSION: CAN, abnormal vascular condition, and sensory function are associated with DR progression. The combination of HF, WS, and CAVI with baseline DR grading provides the most accurate predictive model for DR progression. Early detection of these factors is important to prevent DR progression.

PMID:35348845 | DOI:10.1007/s00417-022-05597-7

Int Orthop. 2022 Mar 29. doi: 10.1007/s00264-022-05388-z. Online ahead of print.

ABSTRACT

PURPOSE: In clinical practice, many patients complained that their knees became larger after total knee arthroplasty (TKA), yet no studies have described this phenomenon. We named this as “patient-perceived enlargement of knee” (PPEK). This study aimed to investigate the prevalence of PPEK after TKA; assess the association between PPEK and demographics, surgical options, or component size; assess the influence of PPEK on patient satisfaction and functional outcomes; and determine whether there was radiological difference between patients with or without PPEK.

METHODS: We reviewed patients that underwent unilateral primary TKA between May 2018 and April 2019. We investigated the prevalence of PPEK and acquired functional scores and satisfaction. Patients were divided into two groups according to whether they complained of PPEK. In radiological evaluation, we measured anterior and posterior condyle offset (ACO and PCO) of the femur, tibial coverage lines, tibial overhanging lines, and femoral overhanging lines.

RESULTS: A total of 389 patients were enrolled and 101 patients felt their knee became “larger” after TKA. Patients with PPEK had significantly shorter height and lower weight, yet component size distribution showed no statistical difference. Patients with PPEK had significantly lower functional scores and satisfaction. Patients with PPEK had significantly larger ACO, shorter postoperative PCO, more ACO increase, and less anterior underhang of the tibia.

CONCLUSION: PPEK is common in TKA patients, especially in individuals with smaller height and weight. PPEK is associated with poor satisfaction and lower functional scores. In radiology, post-operative ACO, PCO, and anterior underhang of the tibial component were correlated with PPEK.

PMID:35348833 | DOI:10.1007/s00264-022-05388-z

Pediatr Radiol. 2022 Mar 29. doi: 10.1007/s00247-022-05333-7. Online ahead of print.

ABSTRACT

BACKGROUND: The value of ¹⁸F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET) in the diagnostic assessment of pediatric fever of unknown origin is not known, and evidence from adults is not applicable.

OBJECTIVE: To quantify the contribution of ¹⁸F-FDG PET to pediatric fever of unknown origin, considering its diagnostic limitations.

MATERIALS AND METHODS: We searched PubMed, EMBASE and Cochrane Central Register of Controlled Trials up to Feb. 18, 2021. We included studies on patients with pediatric fever of unknown origin presenting sufficient data to calculate the likelihood of achieving definite diagnosis (based on pathology or clinical follow-up) between those with abnormal PET findings versus those with normal PET findings. We assessed the risk of bias using a modified Newcastle-Ottawa quality assessment scale and quantified the value of PET by pooling the likelihood of achieving definite diagnosis using a random-effects model.

RESULTS: We included 6 studies and found that pediatric patients with abnormal PET findings were about 17 times more likely to achieve definite diagnoses than those with normal PET findings (odds ratio [OR]: 16.75, 95% confidence interval [CI] 8.0-35, P < 0.00001). Sensitivity analyses using a fixed-effect model (OR 16.91, 95% CI 8.1-35, P < 0.0001) or removing one study at a time (OR 12-20, 95% CI lower bound 3.8-8.6, 95% CI upper bound 33-45, P < 0.0001) did not significantly alter the results. Sample size (interaction P = 0.75), imaging modality (interaction P = 0.29), length of follow-up (interaction P = 0.37), fever of unknown origin subclasses (interaction P = 0.89) and geographical areas (interaction P = 0.74) of studies showed no statistically significant influence on the results.

CONCLUSION: ¹⁸F-FDG PET is a promising approach in the diagnostic work-up of pediatric fever of unknown origin. Further studies are warranted to support routine use in clinical care.

PMID:35348809 | DOI:10.1007/s00247-022-05333-7

J Trop Pediatr. 2022 Mar 28:fmac026. doi: 10.1093/tropej/fmac026. Online ahead of print.

ABSTRACT

BACKGROUND: The first case of COVID-19 in Cameroon was recorded in March 2020. In response to the pandemic, Cameroon like most countries instituted a number of control measures to curb the spread of the pandemic across the country. These COVID-19 control measures added to the fear of this disease within the population may have led to other detrimental health effects like; the pattern of hospitalizations and hospital outcome.

METHODS: We did a cross-sectional study with data from in-patient admission records of children admitted at the pediatric ward of the Regional Hospital Bamenda over a 24 months period, (1st of March 2019 to the 28th of February 2021). The pre-pandemic period in Cameroon (that is the first 12 months, from March 2019-February 2020) and the pandemic period (that is the last 12 months, from March 2020-February 2021) were compared.

RESULTS: A total of 2,282 hospitalization records were included in the study. Most of the hospitalized children were males (57.23%). There was a 19.03% decline in pediatric hospitalizations during the first twelve months of the pandemic, which was statistically significant (P = 0.00024). The causes of hospitalizations and mortality remained similar over both periods, with severe malaria the leading cause of admissions. Hospital deaths before and during the pandemic were 1.6% and 1.9% respectively.

CONCLUSION: There was a statistically significant decline in pediatric hospitalizations during the first twelve months of the pandemic, as compared to the same period before the pandemic. Hospital mortality, and causes of hospitalizations remained similar over both periods.

LAY SUMMARY: The COVID-19 pandemic is a public health emergency and challenge to the health systems of most countries worldwide. The initial response of the Cameroon government to the COVID-19 pandemic was to put a number of measures in place to stop the spread of the virus across the country. These measures, though beneficial in the fight against COVID-19 could have led to other detrimental health effects on the population, through a change in the pattern of hospitalizations and hospital outcome, and all these made worse by the fear of COVID within the population.We carried out a descriptive and retrospective cross sectional study using hospitalization and mortality data from the pediatric ward of the Regional Hospital Bamenda, in Cameroon. We compared the data for the last twelve months before the pandemic (March 2019-February 2020) to that of the first twelve months during the pandemic in Cameroon (March 2020-February 2021).The comparison of the two periods showed that there was a statistically significant decline in pediatric hospitalizations during the first twelve months of the pandemic, by 19.03% (P = 0.00024). The hospital mortality rates before and during the pandemic were 1.6% and 1.9% respectively and the causes of these hospitalizations and mortality remained similar over both periods.

PMID:35348796 | DOI:10.1093/tropej/fmac026

Nicotine Tob Res. 2022 Mar 26;24(5):768-777. doi: 10.1093/ntr/ntab206.

ABSTRACT

INTRODUCTION: The Population Assessment of Tobacco and Health (PATH) Study is a longitudinal cohort study on tobacco use behavior, attitudes and beliefs, and tobacco-related health outcomes, including biomarkers of tobacco exposure in the U.S. population. In this report we provide a summary of urinary nicotine metabolite measurements among adult users and non-users of tobacco from Wave 1 (2013-2014) of the PATH Study.

METHODS: Total nicotine and its metabolites including cotinine, trans-3′-hydroxycotinine (HCTT), and other minor metabolites were measured in more than 11 500 adult participants by liquid chromatography tandem mass spectrometry methods. Weighted geometric means (GM) and least square means from statistical modeling were calculated for non-users and users of various tobacco products.

RESULTS: Among daily users, the highest GM concentrations of nicotine, cotinine and HCTT were found in exclusive smokeless tobacco users, and the lowest in exclusive e-cigarette users. Exclusive combustible product users had intermediate concentrations, similar to those found in users of multiple products (polyusers). Concentrations increased with age within the categories of tobacco users, and differences associated with gender, race/ethnicity and educational attainment were also noted among user categories. Recent (past 12 months) former users had GM cotinine concentrations that were more than threefold greater than never users.

CONCLUSIONS: These urinary nicotine metabolite data provide quantification of nicotine exposure representative of the entire US adult population during 2013-2014 and may serve as a reference for similar analyses in future measurements within this study.

IMPLICATIONS: Nicotine and its metabolites in urine provide perhaps the most fundamental biomarkers of recent nicotine exposure. This report, based on Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study, provides the first nationally representative data describing urinary nicotine biomarker concentrations in both non-users, and users of a variety of tobacco products including combustible, e-cigarette and smokeless products. These data provide a urinary biomarker concentration snapshot in time for the entire US population during 2013-2014, and will provide a basis for comparison with future results from continuing, periodic evaluations in the PATH Study.

PMID:35348786 | DOI:10.1093/ntr/ntab206

J AOAC Int. 2022 Feb 28:qsac030. doi: 10.1093/jaoacint/qsac030. Online ahead of print.

ABSTRACT

BACKGROUND: Green Fourier transform infrared (FTIR) spectroscopy, using potassium bromide (KBr) disc technique, eliminates the consumption of hazardous chemicals. Spectrofluorimetry for drugs that have native fluorescence. Mean centering of ratio spectra (MCRS) analysing overlapped spectra without preliminary separation.

OBJECTIVE: Three simple, accurate, and sensitive methods have been developed and validated for the determination of canagliflozin (CANA); one is a stability-indicating method for CANA and metformin (MET) determination.

METHODS: Method A is FTIR using a KBr disc for CANA determination measuring alkyl halide C-F peak area centered on 1230/cm. Method B is spectrofluorimetry using Δ λ = 50 nm synchronous mode at a peak maximum of 291.8 nm for CANA determination using methanol as solvent. Method C is a stability-indicating MCRS method measuring the peak amplitude of CANA and MET at 306.2 and 246.6 nm, respectively, in their mixture with complete CANA oxidation degradation.

RESULTS: The linear ranges were: FTIR spectroscopy, 1.50-24.70 μg/mg CANA; spectrofluorimetry, 100.00-600.00 ng/mL CANA; and MCRS, 1.00-25.00 μg/mL CANA and 1-30 μg/mL MET.

CONCLUSION: All results were statistically compared with a reported method: no significant difference was observed.

HIGHLIGHTS: The proposed methods can be used efficiently for routine analysis in QC laboratories. A green FTIR method utilizes only one reagent, KBr. Spectrofluorimetry using a constant wavelength synchronous scan of CANA native fluorescence in nanogram concentrations overcomes conventional excitation/emission spectra drawbacks and proves that the solvent effect in the fluorescence intensity differs according to concentration used. Stability-indicating MCRS determines the studied drugs in bulk, pharmaceutical formulations, accelerated and long-term stability study samples.

PMID:35348721 | DOI:10.1093/jaoacint/qsac030

Health Promot Int. 2022 Mar 28:daac023. doi: 10.1093/heapro/daac023. Online ahead of print.

ABSTRACT

Indigenous Standpoint Theory forms the epistemological foundation for this study and methodological choices were made within this theoretical framework to ensure culturally responsive research processes that engaged the Indigenous agenda of self-determination and rights. The objectives of this research were to determine: (i) Indigenous perceptions of the facilitators and barriers to exercise; (ii) The potential feasibility and sustainability of an exercise intervention. In this context, Participatory Action Research methods were used to design the data-gathering instrument for the study-a questionnaire, co-designed with the Noongar Aboriginal community of Perth, Western Australia. This self-administered questionnaire, distributed to participants by email, post and manual delivery, sought to elicit the factors that impact uptake and retention of regular exercise activities. Questionnaire data included individual demographic detail and specific question responses on labelled 5 point Likert Scales. Specific question responses were tabulated by Likert Scale label category and the response distribution for each question was enumerated. Simple descriptive statistics (measures of central tendency and variance) were used to characterize the data set and the Chi squared test was used to evaluate frequency differences between males and females. A total of 133 participants (71 females) completed the questionnaire. The results indicated that people valued exercise. The most common barriers indicated by participants were exercising with an injury (63%), changing diet (58%), finding time to exercise every day (55%) and exercising the next day with pain from exercising the day before (54%). A larger proportion of males (34%) than females (24%) reported greater ease in finding time to exercise every day (p < 0.05). Facilitators mainly related to the potential social and community benefits of exercising with other people, preferably in small groups, and the importance of a culturally secure venue. These findings shed light on what a culturally secure exercise programme might involve for the Noongar community. As this may have implications for other Aboriginal and Torres Strait Islander and international First Nations’ Peoples, more focused research is needed on the place of traditional physical activities and the nature of culturally secure exercise programmes and spaces to enable wider application.

PMID:35348700 | DOI:10.1093/heapro/daac023

J Econ Entomol. 2022 Mar 28:toac012. doi: 10.1093/jee/toac012. Online ahead of print.

ABSTRACT

Myzus persicae (Sulzer, Hemiptera: Aphididae) is a major global crop pest; it is the primary aphid vector for many damaging viruses and has developed resistance to most insecticides. In temperate regions, the risk of widespread crop infection and yield loss is heightened following warm winters, which encourage rapid population growth and early flight. Estimates of the frequency and magnitude of warm winters are, therefore, helpful for understanding and managing this risk. However, it is difficult to quantify the statistical distribution of climate events, particularly extremes, because climate observations represent just a small sample of the possible climate variations in a region. The purpose of this study was to establish a large-scale relationship between temperature and M. persicae observations across the UK and apply this to a very large ensemble of climate model simulations, which better sample the variability in climate, to quantify the current likelihood of extreme early M. persicae flight across the UK. The timing of M. persicae flight was shown to be significantly related to January-February mean temperature, where a 1°C warmer/cooler temperature relates to about 12 d earlier/later flight. Climate model simulations predict 40% likelihood of experiencing a year with unprecedented early M. persicae flight during the next decade in the UK. Results from this method can help crop managers assess the long-term viability of crops and management practices across the UK and provide early warning information for targeting pest surveillance activities on the locations and timings at highest risk of early M. persicae flight.

PMID:35348697 | DOI:10.1093/jee/toac012

Health Promot Int. 2022 Mar 26:daac021. doi: 10.1093/heapro/daac021. Online ahead of print.

ABSTRACT

Cancer is a leading cause of premature death and disability in Samoa. Recognizing the importance of symptom awareness and early detection, the Samoa Cancer Society (SCS) developed the ‘Vave’ (quickly) campaign as the first multi-media cancer awareness campaign in Samoa. The campaign adopted a three-pronged community engagement approach including mass media; printed resources; and community outreach at culturally appropriate locations including churches, villages and schools. The campaign promoted three key messages: detect signs and symptoms quickly; quickly see a doctor; and quickly call SCS. To measure impact, data were collected using several methods around the outreach education sessions (pre- and post-surveys), campaign recall (survey) and Vave-related enquiries received by SCS. The findings revealed the campaign was effective in increasing awareness of cancer and importance of early detection demonstrated through community recall of campaign messages, increased enquiries to SCS and improved knowledge. However, it is of note that almost 30% of campaign recall respondents stated they were unsure or would not see a doctor if concerned about a sign of cancer. The reasons given being a lack of knowledge, lack of trust in hospitals and preference for traditional healing. This suggests more targeted culturally sensitive strategies are needed including partnering with traditional healers. Further, advocacy efforts are needed to address the structural barriers to cancer detection and treatment together with continuing education around causes and symptoms of cancer targeting the hard-to-reach communities in Samoa.

PMID:35348669 | DOI:10.1093/heapro/daac021

Zhongguo Zhong Yao Za Zhi. 2022 Mar;47(6):1625-1631. doi: 10.19540/j.cnki.cjcmm.20211116.401.

ABSTRACT

This study aimed to observe the intervention effect of Jianpi Huogu Formula(JPHGF) on the functional damage of vascular endothelial cells caused by glucocorticoid, and explore its action mechanism from the PI3 K/Akt and mitogen activated protein kinase(MAPK) signaling pathways. The extracted thoracic aorta ring of normal SD rats were intervened first with vascularendothelial growth factor(VEGF, 20 μg·L-1) and/or sodium succinate(MPS, 0. 04 g·L-1) in vitro and then with JPHGF(8, 16, and 32 μg·L-1) for five mcontinuous ethylpdays, rednisolofollowed nebythe statistics of the number, length, and area of microvessels budding fromvascular rings. In addition, the human umbilical vein endothelial cells(HUVECs) induced by VEGF(20 μg·L-1) were added with MPS(0. 04 g·L-1) and then with JPHGF(8, 16, and 32 μg·L-1) for observing the migration, invasion, and luminal formation abilities of HUVECs in the migration, invasion and luminal formation experiments. The protein expression levels of PI3 K, p-Akt, p-JN K, and p-ERK in HUVECs were assayed by Western blot. The results showed that JPHGF dose-dependently improved the num-ber,length, and area of microvessels in MPS-induced rat thoracic aortic ring, reversed the migration, invasion and lumen formation abiliti es of HUVECs reduced by MPS, and up-regulated the protein expression levels of PI3 K, p-Akt, and p-JNK in HUVECs. All thesehave suggested that JPHGF exerts the protective effect against hormone-induced damage to the angiogenesis of vascular endothelial cells by activating the PI3 K/Akt and MAPK signaling pathways, which has provided reference for exploring the mechanism of JPHGF in treating s teroid-induced avascular necrosis of femoral head(SANFH) and also the experimental evidence for enriching the scientific connotationof spleen-invigorating and blood-activating therapy.

PMID:35347971 | DOI:10.19540/j.cnki.cjcmm.20211116.401